Thomas Considine had a big job on his hands when he took over at president and CEO of Meadowlands Hospital Medical Center in May of this year. A number of factors had generated negative press following the hospital’s purchase by an investment group in 2010, and the change from a nonprofit model to a for-profit hospital.

Since that time, Meadowlands Hospital has been in the news regularly for various reasons, including an upgrade in the hospital’s rating from a “C” to an “A,” the signing of a contract with the Veteran’s Administrations to provide services to veterans, and a cutback in staff after it was revealed that less than a quarter of the hospital’s beds were occupied on average.

_____________“There’s no one more unhappy than me about the fact that we don’t have our 2012 financials.” –Thomas Considine____________

Meadowlands was spotlighted again last week after New Jersey Health Commissioner Mary O’Dowd issued a recommendation that all hospitals, including for-profits, disclose their annual financial statements to the public. Considine responded by saying that he agreed with her comments in theory, and in fact would take them one step further.

“I agree with the spirit of what Commissioner O’Dowd wants to go with this,” he told the Secaucus Reporter this week. “But let there be transparency throughout the whole healthcare sector.”

He added that hospitals should not be the only entities held to this requirement. “You have senators who say hospitals are licensed and licenses are precious things and therefore there should be full transparency,” he said. “But managed care companies are licensed, and surgery centers are licensed, and therefore there should be full transparency [in their finances].”

Suggesting that any senate bills be amended to cover all such institutions, he said, “I’ll be very supportive of it.”

However, he disagreed with O’Dowd’s assertion that financials should be disclosed to the public quarterly. In Considine’s estimation, quarterly statements should be considered internal working documents for the hospital.

Nonprofit to for-profit

In late 2013 Meadowlands received an “A” grade in the hospital safety score from The Leapfrog Group, an independent industry watchdog, reflecting how well the hospital protects patients from accidents, errors, injuries, and infections. Meadowlands was also rated one of the top hospitals in New Jersey for patient satisfaction, doctor communication, and patient room/bathroom cleanliness by Inside Jersey magazine.

Asked about any correlation between the change to a for-profit facility and the improvement from a “C” rating to an “A,” Considine said, “There’s a direct correlation because when Meadowlands was part of the Liberty system, it was the afterthought in the Liberty system. When Meadowlands became an independent entity it became the sole focus, and under Dr. Lipsky’s leadership, he was focused on raising the quality level here at this hospital.”

Dr. Richard Lipsky heads MHA LLC, the investment group that purchased Meadowlands Hospital in 2010 for $17.5 million. “Richard Lipsky is a businessman and he wanted and continues to want this hospital to make money,” said Considine. “And he knows that the way to do that is to offer quality healthcare.”

The change from nonprofit to for-profit is part of a larger trend in the region. Within Hudson County, Bayonne Medical Center, Hoboken University Medical Center, and Christ Hospital in Jersey City are also for-profit hospitals, while Jersey City Medical Center and Palisades Medical Center in North Bergen are nonprofits.

As a consequence of Meadowlands becoming for-profit it was required to submit annual audited financial reports to the government. The first of those reports was submitted more than a year late. The second, due more than a year ago, still has not been submitted.

“There’s no one more unhappy than me about the fact that we don’t have our 2012 financials,” said Considine, who added that they are waiting for the reports from an outside firm. “They told us we’ve provided them with more information than any other client of our size. We desperately want to have them because the day after the 2012 financials, we need them to start on 2013. The Department of Health fines us every day.”

Staff adjustments

Recently Considine announced that many of the patient beds were vacant and the hospital was significantly overstaffed. As a result staff would need to be reduced. According to reports, between 30 and 50 beds were occupied in the 230-bed facility.

“There’s a seasonal drop at hospitals,” explained Considine about why the numbers are currently down. “People put off elective procedures in the summer. They don’t want to get procedures before going on vacation.”

Normally a hospital plans for these seasons shifts, he said. “Like a lung expands and contracts with oxygen, a staff does the same based on the season. I asked our staff to see our flexible staffing plan and we didn’t have one. We do now.”

Considine anticipates a better fourth quarter and a strong 2015. The recently signed contract with the Veteran’s Administration will bring new patients to the hospital. Under the contract Meadowlands will treat veterans as part of the HealthNet Federal Services’ Patient-Centered Community Care (PCCC) program, which supplements existing United States Veterans Administration (VA) facilities.

Still, the number of employees remains too high. “There’s a metric in the hospital world called employees-to-occupied-beds,” he continued. “We were way too high. The average is 4.72.”

Meadowlands hospital was reportedly at 17.1.

“We had to try and get closer to a normal number on that and we made adjustments to get that down to just over 10,” he said.

In announcing the situation, Considine stated that the equivalent of 102 jobs would be cut at the hospital, which employs between 400 and 500 people. But reducing staff does not necessarily mean layoffs, he clarified. As a first step, hours were reduced by requiring management to take unpaid furlough days, while retaining benefits. Attrition will account for some job eliminations, with vacant positions not being replaced unless there is a clinical need.

“Our last option is to proceed through layoffs,” he said. “As we sit here today I believe there are only three actual layoffs.”

Perhaps surprisingly, despite the stated need for cutbacks Considine has been praised by Jeanne Otersen, a spokeswoman for the nurses union, for his good faith efforts to turn around the hospital.

“I have a history of working well with collective bargaining employees and their leadership,” he said. “It was high on my priority list.”

Before becoming head of Meadowlands Hospital, Considine was the state commissioner of banking and insurance under Gov. Christopher Christie until February of 2012, then COO of

Magnacare from March 2012 to March 2013.

He is a New Jersey native, born in Bayonne, and is pleased to be back in Hudson County. “I think the world of [Secaucus Mayor] Mike Gonnelli and we’re very proud of the relationship with the town,” he said.